This SBIR project seeks to develop a system capable of remotely monitoring, in real-time, the adherence of an HIV patient to antiretroviral therapy (ART). ART is a medication regimen that once started, needs to be followed for the rest of the patient's life. ART has been successful in improving the quality and expectancy of life of HIV patients as well as in reducing the likelihood of transmission of the disease. However, its success depends on strict adherence to the medication regimen, which is often difficult for patients to accomplish. For this reason, researchers have argued that real-time monitoring of adherence could have a positive impact on adherence rates. This project proposes to accomplish real-time monitoring of adherence using a system that integrates sensors, wireless communications, and Internet technologies. The proposed system will be capable of acquiring information about patient's medication consumption and communicating such information to the appropriate personnel for real-time monitoring of adherence. The proposed system addresses several usability and sensing limitations of competing products on the market. In particular, it will be capable of measuring partial dosing, and may also contribute to measuring pocketing, which are parameters that can only be measured through patient reporting today. This system will be designed and tested by the research team that K&A Wireless has put together for this project, which involves experts on sensors, electronic design, wireless and Internet communications, and ART adherence. This Phase 1 effort will be focused on: 1) designing the electronic hardware capable of acquiring, processing, and transmitting the medication consumption information;2) designing and evaluating the processing software that will estimate the medication consumption based on the sensor information;and 3) designing the communication and computing system to implement the remote real-time monitoring of adherence. The information obtained from the completion of these objectives will provide the hardware and software design for the device that will estimate the medication consumption, and a system-level design for communications of the complete monitoring system. Phase 2 will then be focused on the full development of the system, and on the performance of a clinical trial to evaluate the impact of the proposed system in ART adherence. In this form K&A Wireless expects to deliver by the end of this SBIR effort a working system with demonstrated impact on ART adherence, which is a major concern in today's HIV healthcare. PUBLIC HEALTH RELEVANCE: The success of antiretroviral therapy in improving the life of HIV patients depends on strict adherence to the medication regimen [2, 3]. Since such adherence requirements are challenging for the patient, researchers have suggested that real-time monitoring of adherence could positively impact adherence rates [2]. This motivates the development of a system capable of keeping track of the patient's medication consumption through sensing technology and reporting such information to the provider in real-time.